Doctors may use endoscopic suturing to treat GERD (gastroesophageal reflux disease). Endoscopic suturing aims to tighten the valve at the top of the stomach and reduce acid reflux. It does not aim to reduce acid production by the stomach. The attraction of the procedure is that chronic prescription acid-controlling medication therapy is quite expensive and the hope is that a single, miminally invasive procedure might provide similar symptom relief at decreased long-term cost.
The procedure is performed using a flexible endoscope with a tiny, sewing machine-like device attached that allows the physician to place sutures in two or three different locations near the valve (depending on device used). The physician then ties the sutures together to tighten the valve.
This procedure is performed under mild sedation on an outpatient basis, with patients returning to normal activities the next day.
This is an emerging technology and has not yet been evaluated in large scale or long-term studies or in patients with severe reflux disease. In small, short-term studies (up to 2 years of follow-up in one case), heartburn symptoms seem to significantly improve, but only about 25% of patients were able to come off prescription acid-controlling medications entirely. However, an additional 25-30% were able to reduce the daily amount of medication they needed to take. Further studies are currently underway to continue to evaluate the role this technology will play in the future care of patients with reflux disease.
Last updated: 06-Jun-03